| Autor: |
Qdaisat A; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Wechsler AH; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Cruz Carreras MT; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Menendez JR; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Lipe D; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Highsmith EA; Department of Pharmacy, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Kamal M; Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Al-Breiki A; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.; Department of Emergency Medicine, Sultan Qaboos University Hospital, Al Seeb 121, Oman., Rojas Hernandez CM; Section of Benign Hematology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Wu CC; Department of Thoracic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA., Yeung SJ; Department of Emergency Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA. |
| Abstrakt: |
Incidental venous thromboembolism (VTE) is common in cancer patients and identifying factors associated with these events can improve the management plan. We studied the characteristics of concomitant deep vein thrombosis (C-DVT) in cancer patients presenting with unsuspected pulmonary embolism (PE) and the association of C-DVT with VTE recurrence and survival outcomes. Patients presenting to our emergency department with confirmed unsuspected/incidental PE between 1 January 2006 and 1 January 2016, were identified. Radiologic reports were reviewed to confirm the presence or absence of C-DVT. Logistic regression analyses and cox regression modeling were used to determine the effect of C-DVT on VTE recurrence and survival outcomes. Of 904 eligible patients, 189 (20.9%) had C-DVT. Patients with C-DVT had twice the odds of developing VTE recurrence (odds ratio 2.07, 95% confidence interval 1.21-3.48, p = 0.007). The mortality rates among C-DVT were significantly higher than in patients without. C-DVT was associated with reduced overall survival in patients with unsuspected PE (hazard ratio 1.33, 95% confidence interval 1.09-1.63, p = 0.005). In conclusion, C-DVT in cancer patients who present with unsuspected PE is common and is associated with an increased risk of VTE recurrence and poor short- and long-term survival. Identifying other venous thrombi in cancer patients presenting with unsuspected PE is recommended and can guide the management plan. For patients with isolated incidental subsegmental pulmonary embolism and concomitant deep vein thrombosis, initiating anticoagulants if no contraindications exist is recommended. |
